www.cms.gov: Accessibility — week 2026-W28

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	5519	4	Component inconsistency
2.5.5	WCAG 2.5.5	3699	1
1.4.6	WCAG 1.4.6	1624	1
2.5.3	WCAG 2.5.3	1621	1
1.3.1	Info and Relationships (semantic structure)	1260	10

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Design-system alignment (cms-ds / default). ds-c-spinner: 100% of sampled rule findings · ds-c-pagination: 11.1% of sampled rule findings

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Form field label is visible · unattributed component Fix one place, resolve ~3656 finding(s) on 3656 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	3656	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~1369 finding(s) on 1369 page(s). XPath / selector: `text: "Feedback"`	Moderate	1369	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~76 finding(s) on 76 page(s). XPath / selector: `#q` `<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">`	Critical	76	Without vision, Limited vision, Limited manipulation/strength	Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~79 finding(s) on 79 page(s). XPath / selector: `html` `<html>`	Serious	79	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~1618 finding(s) on 1618 page(s). XPath / selector: `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`	Moderate	1618	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~111 finding(s) on 111 page(s). XPath / selector: `html` `<html>`	Moderate	111	Requires manual testing.	See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~1489 finding(s) on 1489 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	1489	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~79 finding(s) on 79 page(s). XPath / selector: `html` `<html>`	Moderate	79	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Element has required aria-owns · unattributed component Fix one place, resolve ~338 finding(s) on 193 page(s). XPath / selector: `<th scope="col">`	Moderate	193	Without vision, Limited vision, Limited cognitive, language, or learning ability	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46	pages (CSV)	Decision Assigned to Notes
Document has a valid lang attribute · unattributed component Fix one place, resolve ~42 finding(s) on 42 page(s). XPath / selector: `<html>`	Moderate	42	Without vision, Limited cognitive, language, or learning ability	Add a valid lang attribute to <html>.	pages (CSV)	Decision Assigned to Notes

Bug reports

12 issue type(s) are shown by default out of 43 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 5 critical, 6 serious, 29 moderate, 3 minor. By WCAG category: 18 WCAG 2.0 A, 3 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 10 Best Practice, 9 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 12 prioritized issue type(s); 31 more are available if you switch to "Show everything".

5 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 79/8594 pages · 79 instances Likely template

Bug ID: VS-d07459a7
Pattern ID: VS-c126b6a6
Combined ID: VS-d07459a7 (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 79 of 8594 scanned pages (79 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: html
Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 79 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add a lang attribute to <html> (e.g. lang="en").

Drupal tip: Drupal sets the page lang attribute from Admin › Configuration › Regional and Language › Languages. Ensure the default language is configured.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 76/8594 pages · 76 instances Likely template

Bug ID: VS-ce188237
Pattern ID: VS-fafffee0
Combined ID: VS-ce188237 (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W28 (3 wk)

HTML snippet — use this to validate the finding without re-running the tool

<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">

Description

Form elements must have labels. Detected by axe-core rule label on 76 of 8594 scanned pages (76 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

…and more — all 76 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.

Drupal tip: Use Drupal's form element "Label" setting. In Webform, every element has a Label field — ensure it's not empty or hidden. Check that twig templates don't strip <label> elements from form fields.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 7/8594 pages · 18 instances

Bug ID: VS-684fe449
Pattern ID: VS-e9fe47ac
Combined ID: VS-684fe449 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://www.cms.gov/medicare/appeals-grievances/fee-for-service/fourth-level-appeal
XPath / selector: p:nth-child(9) > a[data-once="linkMatch"]:nth-child(2)
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&amp;SID=934b72c9c14240880948b1590c0844b1&amp;rgn=div5&amp;view=text&amp;node=42:2.0.1.2.5&amp;idno=42#se42.2.405_11100" data-once="linkMatch"> </a

Description

Links must have discernible text. Detected by axe-core rule link-name on 8 of 8594 scanned pages (21 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/appeals-grievances/fee-for-service/fourth-level-appeal.
Locate the element: p:nth-child(9) > a[data-once="linkMatch"]:nth-child(2)
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the link discernible text. Avoid empty links and icon-only links without an aria-label.

Drupal tip: "Read more" links from Drupal Views should use the "Link text" rewrite field to add context, or add aria-label via the Views rewrite output.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI

Triage status Notes

Serious axe td-headers-attr WCAG 2.0 A Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1) 5/8594 pages · 5 instances

Bug ID: VS-44a25e7b
Pattern ID: VS-07ba3b17
Combined ID: VS-44a25e7b (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table class="MsoTableGrid">

Description

Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 5 of 8594 scanned pages (5 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc.
Locate the element: .MsoTableGrid
Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate data cells with their headers correctly using headers/id or scope.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 4/8594 pages · 4 instances

Bug ID: VS-430dc11a
Pattern ID: VS-9074b4dd
Combined ID: VS-430dc11a (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=265
XPath / selector: img[border="0"]
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img border="0" width="592" height="433" src="https://www.cms.gov/medicare/coverage/determinationprocess/other-content-types/id265DMFigurepng.png" v:shapes="Picture_x0020_1">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 5 of 8594 scanned pages (5 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=265.
Locate the element: img[border="0"]
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

Drupal tip: In Drupal's Media Library, fill the "Alternative text" field when uploading or editing an image. For images in body fields, the CKEditor "Image Properties" dialog includes an Alt Text field.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

Triage status Notes

Serious axe list WCAG 2.0 A <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1) 4/8594 pages · 483 instances Likely template

Bug ID: VS-361e0f9f
Pattern ID: VS-a0bdbdf6
Combined ID: VS-361e0f9f (pattern VS-a0bdbdf6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — <ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55533&ver=2
XPath / selector: td:nth-child(2) > ul
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<ul>

Description

<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 716 of 8594 scanned pages (3021 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55533&ver=2.
Locate the element: td:nth-child(2) > ul
Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI

Triage status Notes

Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 2/8594 pages · 5 instances Likely content

Bug ID: VS-457bf7d3
Pattern ID: VS-1467ea8a
Combined ID: VS-457bf7d3 (pattern VS-1467ea8a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Elements must only use supported ARIA attributes [aria-allowed-attr]
Example URL: http://cms.gov/medicare/health-drug-plans/provider-complaints-form
XPath / selector: .choices__placeholder
History: first seen 2026-W25, last seen 2026-W28 (3 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="[object Object]" aria-selected="true">Start typing to filter li

Description

Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 2 of 8594 scanned pages (5 instances).

Steps to reproduce

Open http://cms.gov/medicare/health-drug-plans/provider-complaints-form.
Locate the element: .choices__placeholder
Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove ARIA attributes that aren't allowed on this role/element.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI

Triage status Notes

Critical axe button-name WCAG 2.0 A Buttons must have discernible text (WCAG 4.1.2) 1/8594 pages · 1 instances Likely content

Bug ID: VS-a23b8a72
Pattern ID: VS-e7298c00
Combined ID: VS-a23b8a72 (pattern VS-e7298c00) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Buttons must have discernible text [button-name]
Example URL: https://www.cms.gov/priorities/innovation/files/access-fin-struct-clin-perf-video
XPath / selector: .ytSideRailViewModelHideButton > .ytSpecButtonShapeNextSizeL.ytSpecButtonShapeNextText.ytSpecButtonShapeNextIconButton
History: first seen 2026-W26, last seen 2026-W28 (2 wk)

HTML snippet — use this to validate the finding without re-running the tool

<button class="ytSpecButtonShapeNextHost ytSpecButtonShapeNextText ytSpecButtonShapeNextMono ytSpecButtonShapeNextSizeL ytSpecButtonShapeNextIconButton ytSpecButtonShapeNextEnableBackdropFilterExperim

Description

Buttons must have discernible text. Detected by axe-core rule button-name on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/priorities/innovation/files/access-fin-struct-clin-perf-video.
Locate the element: .ytSideRailViewModelHideButton > .ytSpecButtonShapeNextSizeL.ytSpecButtonShapeNextText.ytSpecButtonShapeNextIconButton
Confirm the axe-core finding for rule button-name against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

/priorities/innovation/files/access-fin-struct-clin-perf-video

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the button an accessible name via its text content, aria-label, or aria-labelledby.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/button-name?application=axeAPI

Triage status Notes

Critical axe aria-required-children WCAG 2.0 A Certain ARIA roles must contain particular children (WCAG 1.3.1) 1/8594 pages · 1 instances Likely content

Bug ID: VS-f755d264
Pattern ID: VS-9429bb8d
Combined ID: VS-f755d264 (pattern VS-9429bb8d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Certain ARIA roles must contain particular children [aria-required-children]
Example URL: http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html
XPath / selector: #SERVICES
History: first seen 2026-W28, last seen 2026-W28 (1 wk)

HTML snippet — use this to validate the finding without re-running the tool

<ul id="SERVICES" class="closed openMenu" role="menu" tabindex="-1" style="background-color: rgb(255, 255, 255); margin-bottom: 60px;">

Description

Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html.
Locate the element: #SERVICES
Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add the child roles this container role requires (e.g. a list needs listitem children).

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/8594 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings
XPath / selector: a[href$="#_ftnref1"] > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span lang="X-NONE">[1]</span>

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
Locate the element: a[href$="#_ftnref1"] > span[lang="X-NONE"]
Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 1/8594 pages · 1 instances Likely content

Bug ID: VS-b3306ef1
Pattern ID: VS-bd13f00a
Combined ID: VS-b3306ef1 (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/FY2027-nprm-v44-fullcode-cms/fullcode_cms/P0001.html
XPath / selector: td[width="31"]:nth-child(4) > a[accesskey="n"][href$="P0002.html"]
History: first seen 2026-W25, last seen 2026-W28 (3 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a accesskey="n" id="next_page" href="P0002.html"><img src="fwdpg.png" alt="Next Page [Alt-n]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a>

Description

accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2027-nprm-v44-fullcode-cms/fullcode_cms/P0001.html.
Locate the element: td[width="31"]:nth-child(4) > a[accesskey="n"][href$="P0002.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/FY2027-nprm-v44-fullcode-cms/fullcode_cms/P0001.html

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 42/8594 pages · 42 instances · possible duplicate Likely template

Bug ID: VS-fe4478a1
Pattern ID: VS-7a0e5645
Combined ID: VS-fe4478a1 (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W28 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-d07459a7 (pattern VS-c126b6a6). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 42 of 8594 scanned pages (42 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: <html>
Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 42 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add a valid lang attribute to <html>.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 1370/8594 pages · 1370 instances Likely template

Bug ID: VS-7f75d6ab
Pattern ID: VS-c18be945
Combined ID: VS-7f75d6ab (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 1370 of 8594 scanned pages (1370 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 1370 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 111/8594 pages · 111 instances Likely template

Bug ID: VS-4699f5ee
Pattern ID: VS-fa44f293
Combined ID: VS-4699f5ee (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 111 of 8594 scanned pages (111 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 111 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 80/8594 pages · 1843 instances Likely template

Bug ID: VS-8ef5c83c
Pattern ID: VS-f18df681
Combined ID: VS-8ef5c83c (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: .hhshead[cellpadding="0"][cellspacing="0"]:nth-child(1)
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table class="hhshead" cellpadding="0" cellspacing="0" summary="HHS Header. Table for formatting only.">

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 80 of 8594 scanned pages (1843 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: .hhshead[cellpadding="0"][cellspacing="0"]:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 80 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

Drupal tip: Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 79/8594 pages · 79 instances Likely template

Bug ID: VS-2a51f6fd
Pattern ID: VS-d5d82446
Combined ID: VS-2a51f6fd (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 79 of 8594 scanned pages (79 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 79 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Each page should have exactly one <main> landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 42/8594 pages · 84 instances Likely template

Bug ID: VS-7aa85a99
Pattern ID: VS-e43903a1
Combined ID: VS-7aa85a99 (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W28 (3 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 42 of 8594 scanned pages (84 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 42 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 42/8594 pages · 42 instances Likely template

Bug ID: VS-2cb8a020
Pattern ID: VS-7fbb8b20
Combined ID: VS-2cb8a020 (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W28 (3 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 42 of 8594 scanned pages (42 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 42 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 13/8594 pages · 67208 instances Likely template

Bug ID: VS-11f050f8
Pattern ID: VS-cb53cc4d
Combined ID: VS-11f050f8 (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: <a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3699 of 8594 scanned pages (129247 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: <a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 13/8594 pages · 22443 instances Likely template

Bug ID: VS-2ae92e82
Pattern ID: VS-2208081b
Combined ID: VS-2ae92e82 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 3695 of 8594 scanned pages (43159 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: <p class="usa-banner__header-text">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 13/8594 pages · 1901 instances Likely template

Bug ID: VS-711bae61
Pattern ID: VS-7118fead
Combined ID: VS-711bae61 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 3656 of 8594 scanned pages (3656 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 12/8594 pages · 326 instances Likely template

Bug ID: VS-c76d6a69
Pattern ID: VS-d25f622d
Combined ID: VS-c76d6a69 (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">Report Information</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 659 of 8594 scanned pages (679 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 9/8594 pages · 9 instances

Bug ID: VS-ecd36871
Pattern ID: VS-8806389c
Combined ID: VS-ecd36871 (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: http://cms.gov/priorities/health-equity/minority-health/research-data/research-data/tools
XPath / selector: .ds-u-lg-padding--0.ds-u-lg-margin-y--4.ds-u-margin-y--3:nth-child(7) > .ds-l-md-col--4.ds-u-padding-x--0.ds-u-md-padding-x--2 > div[role="region"]
History: first seen 2026-W25, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div role="region">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 9 of 8594 scanned pages (9 instances).

Steps to reproduce

Open http://cms.gov/priorities/health-equity/minority-health/research-data/research-data/tools.
Locate the element: .ds-u-lg-padding--0.ds-u-lg-margin-y--4.ds-u-margin-y--3:nth-child(7) > .ds-l-md-col--4.ds-u-padding-x--0.ds-u-md-padding-x--2 > div[role="region"]
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 9/8594 pages · 10 instances Likely template

Bug ID: VS-703f0347
Pattern ID: VS-0066c67d
Combined ID: VS-703f0347 (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: http://www.cms.gov/about-cms/work-us/careers/careers-frequently-asked-questions-faq
XPath / selector: h2:nth-child(91)
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h2>&nbsp;</h2>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 11 of 8594 scanned pages (12 instances).

Steps to reproduce

Open http://www.cms.gov/about-cms/work-us/careers/careers-frequently-asked-questions-faq.
Locate the element: h2:nth-child(91)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 7/8594 pages · 259 instances Likely template

Bug ID: VS-c9a4ae3e
Pattern ID: VS-04a9d28c
Combined ID: VS-c9a4ae3e (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53423&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16
XPath / selector: p
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<p align="LEFT">CMS-Internet Only Manual, Pub 100-04, Medicare Claims Processing Manual, Chapter 13, Section 100.1.</p>

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 38 of 8594 scanned pages (924 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53423&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16.
Locate the element: p
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 4/8594 pages · 39 instances Likely template

Bug ID: VS-65e58df6
Pattern ID: VS-f7e99f4b
Combined ID: VS-65e58df6 (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events
XPath / selector: text: "FEB"
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 27 of 8594 scanned pages (241 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events.
Locate the element: text: "FEB"
Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

Impact

Affects Limited vision (2.4%), Without color perception (4.5%).

Limited vision — 2.4% of population
Without color perception — 4.5% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 4/8594 pages · 4 instances · possible duplicate

Bug ID: VS-7d6ca202
Pattern ID: VS-3c632d31
Combined ID: VS-7d6ca202 (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: http://www.cms.gov/about-cms/work-us/careers/careers-frequently-asked-questions-faq
XPath / selector: <h2>
History: first seen 2026-W24, last seen 2026-W28 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-44a25e7b (pattern VS-07ba3b17). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 5 of 8594 scanned pages (5 instances).

Steps to reproduce

Open http://www.cms.gov/about-cms/work-us/careers/careers-frequently-asked-questions-faq.
Locate the element: <h2>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

Triage status Notes

Moderate alfa sia-r45 WCAG 2.0 A aria-hidden element is not exposed to assistive technology (WCAG 1.3.1) 3/8594 pages · 175 instances · possible duplicate

Bug ID: VS-b60e3935
Pattern ID: VS-9207ed51
Combined ID: VS-b60e3935 (pattern VS-9207ed51) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — aria-hidden element is not exposed to assistive technology [sia-r45]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc
XPath / selector: @headers="view-field-dyna-cr-number-table-column"
History: first seen 2026-W26, last seen 2026-W28 (2 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-44a25e7b (pattern VS-07ba3b17). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 3 of 8594 scanned pages (175 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc.
Locate the element: @headers="view-field-dyna-cr-number-table-column"
Confirm the Siteimprove Alfa finding for rule sia-r45 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r45

Triage status Notes

Moderate alfa sia-r40 Undetermined Tables are used for tabular data, not layout (WCAG criterion undetermined) 3/8594 pages · 7 instances

Bug ID: VS-f80b6065
Pattern ID: VS-3d3b2245
Combined ID: VS-f80b6065 (pattern VS-3d3b2245) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Tables are used for tabular data, not layout [sia-r40]
Example URL: http://cms.gov/priorities/health-equity/minority-health/research-data/research-data/tools
XPath / selector: <div role="region">
History: first seen 2026-W27, last seen 2026-W28 (2 wk)

Description

Tables are used for tabular data, not layout. Detected by Siteimprove Alfa rule sia-r40 on 3 of 8594 scanned pages (7 instances).

Steps to reproduce

Open http://cms.gov/priorities/health-equity/minority-health/research-data/research-data/tools.
Locate the element: <div role="region">
Confirm the Siteimprove Alfa finding for rule sia-r40.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r40

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 3/8594 pages · 5 instances

Bug ID: VS-069bdce6
Pattern ID: VS-28ebd979
Combined ID: VS-069bdce6 (pattern VS-28ebd979) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link has accessible name [sia-r11]
Example URL: https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments?redirect=%2Fclia
XPath / selector: <a href="/files/document/clia-cert-quick-start-guide.pdf" data-entity-substitution="canonical" data-entity-type="media" data-entity-uuid="27ce5119-858b-44f2-bbc6-c5d2d56ce4f0">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 3 of 8594 scanned pages (5 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments?redirect=%2Fclia.
Locate the element: <a href="/files/document/clia-cert-quick-start-guide.pdf" data-entity-substitution="canonical" data-entity-type="media" data-entity-uuid="27ce5119-858b-44f2-bbc6-c5d2d56ce4f0">
Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the link an accessible name via text content or aria-label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11

Triage status Notes

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 2/8594 pages · 2 instances Likely content

Bug ID: VS-6624ac36
Pattern ID: VS-aa242c2d
Combined ID: VS-6624ac36 (pattern VS-aa242c2d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — First focusable element is link to main content [sia-r87]
Example URL: https://cms.gov/priorities/electronic-prior-authorization/overview
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W25, last seen 2026-W28 (4 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 2 of 8594 scanned pages (2 instances).

Steps to reproduce

Open https://cms.gov/priorities/electronic-prior-authorization/overview.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r87.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

Triage status Notes

Moderate alfa sia-r62 WCAG 2.0 A Link in text block is visually distinguishable without color (WCAG 1.4.1) 2/8594 pages · 2 instances

Bug ID: VS-245fe11b
Pattern ID: VS-efd91fdd
Combined ID: VS-245fe11b (pattern VS-efd91fdd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.4.1 Use of Color (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link in text block is visually distinguishable without color [sia-r62]
Example URL: http://www.cms.gov/medicare-coverage-database/search.aspx
XPath / selector: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 7 of 8594 scanned pages (7 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/search.aspx.
Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">
Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

Impact

Affects Without color perception (4.5%), Limited vision (2.4%).

Without color perception — 4.5% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 1/8594 pages · 54 instances Likely template

Bug ID: VS-aa7d5e0a
Pattern ID: VS-d6097011
Combined ID: VS-aa7d5e0a (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: <tfoot>
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 315 of 8594 scanned pages (1362 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: <tfoot>
Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/priorities/innovation/events/esrd-intro-webinar

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 1/8594 pages · 41 instances Likely template

Bug ID: VS-3a814f80
Pattern ID: VS-2cd767ca
Combined ID: VS-3a814f80 (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title
XPath / selector: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 614 of 8594 scanned pages (1015 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37616&lcdStatus=all&sortBy=title.
Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/medicare/settlements/ryan

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 1/8594 pages · 40 instances Likely template

Bug ID: VS-f1856628
Pattern ID: VS-179ad9b3
Combined ID: VS-f1856628 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54635&articleStatus=all&bc=3&sortBy=title&ver=31
XPath / selector: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 538 of 8594 scanned pages (1000 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54635&articleStatus=all&bc=3&sortBy=title&ver=31.
Locate the element: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).

Limited manipulation/strength — 13.0% of population
Limited reach — 2.0% of population
Limited vision — 2.4% of population

Affected pages

/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113

Triage status Notes

Moderate alfa sia-r42 WCAG 2.0 A Element in required WAI-ARIA context role (WCAG 1.3.1) 1/8594 pages · 5 instances Likely content

Bug ID: VS-6e66be08
Pattern ID: VS-0ddc2ac6
Combined ID: VS-6e66be08 (pattern VS-0ddc2ac6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element in required WAI-ARIA context role [sia-r42]
Example URL: https://www.cms.gov/
XPath / selector: <button type="button" id="trigger-tabs-1108423468" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

Description

Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 8594 scanned pages (5 instances).

Steps to reproduce

Open https://www.cms.gov/.
Locate the element: <button type="button" id="trigger-tabs-1108423468" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">
Confirm the Siteimprove Alfa finding for rule sia-r42 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r42

Triage status Notes

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 1/8594 pages · 1 instances Likely content

Bug ID: VS-cc2fa4a9
Pattern ID: VS-e05344b9
Combined ID: VS-cc2fa4a9 (pattern VS-e05344b9) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — aria attribute is permitted for element role [sia-r18]
Example URL: http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html
XPath / selector: @aria-expanded="true"
History: first seen 2026-W25, last seen 2026-W28 (4 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html.
Locate the element: @aria-expanded="true"
Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

Triage status Notes

Moderate axe landmark-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 1/8594 pages · 1 instances Likely content

Bug ID: VS-6263cb63
Pattern ID: VS-30db094d
Combined ID: VS-6263cb63 (pattern VS-30db094d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]
Example URL: https://www.cms.gov/data-research/statistics-trends-and-reports/mcbs-public-use-file
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<header class="Header" style="position: sticky;">

Description

Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/statistics-trends-and-reports/mcbs-public-use-file.
Locate the element: .Header
Confirm the axe-core finding for rule landmark-banner-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/data-research/statistics-trends-and-reports/mcbs-public-use-file

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Put the banner landmark (<header>) at the top level, not nested inside another landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI

Triage status Notes

Moderate alfa sia-r8 WCAG 2.0 A Form field has accessible name (WCAG 4.1.2) 1/8594 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-ee1076f7
Pattern ID: VS-a48e6078
Combined ID: VS-ee1076f7 (pattern VS-a48e6078) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Form field has accessible name [sia-r8]
Example URL: http://cms.gov/medicare/health-drug-plans/provider-complaints-form
XPath / selector: <div class="choices__list" role="listbox">
History: first seen 2026-W25, last seen 2026-W28 (4 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-a23b8a72 (pattern VS-e7298c00). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open http://cms.gov/medicare/health-drug-plans/provider-complaints-form.
Locate the element: <div class="choices__list" role="listbox">
Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

/medicare/health-drug-plans/provider-complaints-form

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate the form field with a label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 1/8594 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-b17374d3
Pattern ID: VS-a24eaa8c
Combined ID: VS-b17374d3 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: https://cms.gov/priorities/electronic-prior-authorization/overview
XPath / selector: <img src="https://static-assets.qualtrics.com/static/prototype-ui-modules/SharedGraphics/siteintercept/svg-close-btn-white-1.svg">
History: first seen 2026-W24, last seen 2026-W28 (4 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-0892d964 (pattern VS-f7280372). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://cms.gov/priorities/electronic-prior-authorization/overview.
Locate the element: <img src="https://static-assets.qualtrics.com/static/prototype-ui-modules/SharedGraphics/siteintercept/svg-close-btn-white-1.svg">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/priorities/electronic-prior-authorization/overview

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

Triage status Notes

Moderate axe meta-viewport WCAG 2.0 AA Zooming and scaling must not be disabled (WCAG 1.4.4) 1/8594 pages · 1 instances Likely content

Bug ID: VS-12bbe3e5
Pattern ID: VS-6c86a43a
Combined ID: VS-12bbe3e5 (pattern VS-6c86a43a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.4 Resize Text (Level AA, WCAG 2.0)
Rule: axe-core — Zooming and scaling must not be disabled [meta-viewport]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html
XPath / selector: meta[name="viewport"]
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">

Description

Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html.
Locate the element: meta[name="viewport"]
Confirm the axe-core finding for rule meta-viewport against WCAG 1.4.4 Resize Text.

Impact

Affects Limited vision (2.4%).

Limited vision — 2.4% of population

Affected pages

/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Don't disable zoom (user-scalable=no / maximum-scale=1); low-vision users need to zoom.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI

Triage status Notes

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 1/8594 pages · 1 instances Likely content

Bug ID: VS-55974bf3
Pattern ID: VS-4fac2f41
Combined ID: VS-55974bf3 (pattern VS-4fac2f41) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — ARIA role should be appropriate for the element [aria-allowed-role]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html
XPath / selector: body
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<body style="background: #072137" class="cs-HTML theme-unified view-desktop is-landscape ff-on ff-drop-in-base ff-js-api-basics ff-multiple-quiz-tracking ff-native-prompts ff-player-size-option sideba

Description

ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 1 of 8594 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html.
Locate the element: body
Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove or change the ARIA role — it isn't allowed on this element type.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI

Triage status Notes

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 1/8594 pages · 1 instances Likely template

Bug ID: VS-e983053f
Pattern ID: VS-d69fc059
Combined ID: VS-e983053f (pattern VS-d69fc059) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Table header text should not be empty [empty-table-header]
Example URL: https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=16&sortBy=meetingdate&year=all
XPath / selector: th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<th valign="top" width="25%" scope="col">&nbsp;</th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 13 of 8594 scanned pages (18 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=16&sortBy=meetingdate&year=all.
Locate the element: th:nth-child(1)
Confirm the axe-core finding for rule empty-table-header.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/newsroom/fact-sheets/2025-medicare-advantage-part-d-star-ratings

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (26 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W28, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	1003	2242	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 1003 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	716	3021	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/article.aspx	all 716 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	659	679	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 659 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	111	111	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0307.html /icd10m/version33-fullcode-cms/fullcode_cms/P0388.html	all 111 pages (CSV)
All page content should be contained by landmarks [region]	moderate	80	1843	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0307.html /icd10m/version33-fullcode-cms/fullcode_cms/P0388.html	all 80 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	79	79	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0307.html /icd10m/version33-fullcode-cms/fullcode_cms/P0388.html	all 79 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	79	79	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0307.html /icd10m/version33-fullcode-cms/fullcode_cms/P0388.html	all 79 pages (CSV)
Form elements must have labels [label]	critical	76	76	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0307.html /icd10m/version33-fullcode-cms/fullcode_cms/P0388.html	all 76 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	61	773	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 61 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	21	471	/medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 21 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	13	18	/medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/article.aspx	all 13 pages (CSV)
Headings should not be empty [empty-heading]	minor	11	12	/about-cms/work-us/careers/careers-frequently-asked-questions-faq /hospitals-information-center /about-cms/what-we-do/nursing-homes	all 11 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	9	51	/medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/ncacal-tracking-sheet.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx	all 9 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	9	9	/priorities/health-equity/minority-health/research-data/research-data/tools /priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars /priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars	all 9 pages (CSV)
Links must have discernible text [link-name]	serious	8	21	/medicare/appeals-grievances/fee-for-service/fourth-level-appeal /medicare-coverage-database/view/ncacal-decision-memo.aspx /newsroom/fact-sheets/cy-2023-home-health-prospective-payment-system-rate-update-home-infusion-therapy-services-0	all 8 pages (CSV)
Images must have alternative text [image-alt]	critical	5	5	/medicare-coverage-database/details/nca-decision-memo.aspx /icd10m/FY2024-version41.1-fullcode-cms/fullcode_cms/P0001.html /priorities/electronic-prior-authorization/overview	all 5 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	5	5	/medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 5 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	2	5	/medicare/health-drug-plans/provider-complaints-form /files/linked-video-files/new-features-medicare-gov	all 2 pages (CSV)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	1	1	/data-research/statistics-trends-and-reports/mcbs-public-use-file	all 1 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	1	1	/icd10m/FY2027-nprm-v44-fullcode-cms/fullcode_cms/P0001.html	all 1 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children]	critical	1	1	/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html	all 1 pages (CSV)
ARIA progressbar nodes must have an accessible name [aria-progressbar-name]	serious	1	1	/medicare-coverage-database/search-results.aspx	all 1 pages (CSV)
Buttons must have discernible text [button-name]	critical	1	1	/priorities/innovation/files/access-fin-struct-clin-perf-video	all 1 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	1	1	/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html	all 1 pages (CSV)
Zooming and scaling must not be disabled [meta-viewport]	moderate	1	1	/Outreach-and-Education/MLN/WBT/PartDDeterminations/story.html	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (32 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W28, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	3699	129247	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn /health-technology-ecosystem/categories	all 3699 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	3695	43159	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn /health-technology-ecosystem/categories	all 3695 pages (CSV)
Form field label is visible [sia-r61]	n/a	3656	3656	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn /health-technology-ecosystem/categories	all 3656 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	1654	1660	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx /medicare-coverage-database/view/article.aspx	all 1654 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	1624	8888	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx /medicare-coverage-database/view/article.aspx	all 1624 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	1622	111410	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx /medicare-coverage-database/view/article.aspx	all 1622 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	1621	4090	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx /medicare-coverage-database/view/article.aspx	all 1621 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	1370	1370	/medicare/regulations-guidance/transmittals/2025-transmittals/r13560otn /medicare/regulations-guidance/transmittals/2021-transmittals /priorities/health-equity/minority-health/resource-center/health-care-professionals-researchers	all 1370 pages (CSV)
Table header has scope [sia-r78]	n/a	614	1015	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 614 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	538	1000	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 538 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	315	1362	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx	all 315 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	195	340	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 195 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	125	1313	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 125 pages (CSV)
iframe element is not empty [sia-r71]	n/a	77	2798	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 77 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	42	84	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0304.html /icd10m/version33-fullcode-cms/fullcode_cms/P0103.html	all 42 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	42	42	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0304.html /icd10m/version33-fullcode-cms/fullcode_cms/P0103.html	all 42 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	42	42	/icd10m/version33-fullcode-cms/fullcode_cms/P0180.html /icd10m/version33-fullcode-cms/fullcode_cms/P0304.html /icd10m/version33-fullcode-cms/fullcode_cms/P0103.html	all 42 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	27	241	/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/medicare-coverage-document.aspx	all 27 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	18	18	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 18 pages (CSV)
Table cell has header [sia-r77]	n/a	10	93	/medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 10 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	8	8	/medicare-coverage-database/details/nca-proposed-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 8 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	7	44	/medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 7 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	7	7	/medicare-coverage-database/search.aspx /newsroom/data /medicare-coverage-database/view/article.aspx	all 7 pages (CSV)
Element has required owned roles [sia-r64]	n/a	5	5	/about-cms/work-us/careers/careers-frequently-asked-questions-faq /about-cms/what-we-do/nursing-homes /medicare-coverage-database/view/lcd.aspx	all 5 pages (CSV)
aria-hidden element is not exposed to assistive technology [sia-r45]	n/a	3	175	/medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2020-transmittals	all 3 pages (CSV)
Tables are used for tabular data, not layout [sia-r40]	n/a	3	7	/priorities/health-equity/minority-health/research-data/research-data/tools /priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars /data-tools	all 3 pages (CSV)
Link has accessible name [sia-r11]	n/a	3	5	/medicare/quality/clinical-laboratory-improvement-amendments /medicare/quality/clinical-laboratory-improvement-amendments /newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney	all 3 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	2	2	/priorities/electronic-prior-authorization/overview /Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html	all 2 pages (CSV)
Element in required WAI-ARIA context role [sia-r42]	n/a	1	5	/	all 1 pages (CSV)
Form field has accessible name [sia-r8]	n/a	1	1	/medicare/health-drug-plans/provider-complaints-form	all 1 pages (CSV)
Image has accessible name [sia-r2]	n/a	1	1	/priorities/electronic-prior-authorization/overview	all 1 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	1	1	/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (23983 raw engine findings → 23929 unique).

Unique issues (rule × page): 23929
Caught by both engines: 54 highest confidence
axe only: 2901
Alfa only: 20974

8 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W28, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	79	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Form elements must have labels	77	axe label · Alfa sia-r8 · ACT e086e5
Headings should not be empty	11	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Links must have discernible text	8	axe link-name · Alfa sia-r11 · ACT c487ae
Images must have alternative text	5	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Table cell headers attributes must refer to other <th> elements in the same table	5	axe td-headers-attr · Alfa sia-r45 · ACT a25f45
Elements must only use supported ARIA attributes	3	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
Certain ARIA roles must contain particular children	2	axe aria-required-children · Alfa sia-r42 · ACT ff89c9